Superficial Temporal Vessels as Recipient Sites in Head and Neck Reconstruction: Clinical Outcomes From a Single-Center Retrospective Cohort Study

Background: The superficial temporal vessels represent an alternative recipient site for microvascular reconstruction of complex head and neck defects, particularly when cervical vessels are inaccessible or unsuitable.However, concerns regarding vessel caliber, venous drainage, and intraoperative reliability remain.This study aimed to evaluate clinical outcomes and technical challenges associated with the use of superficial temporal vessels in maxillofacial reconstruction.Methods: A single-center retrospective study was conducted involving 20 consecutive patients in whom superficial temporal vessels were selected as potential recipient sites between January 2019 and December 2025.Patient characteristics, reconstructive techniques, recipient vessel selection, flap survival, intraoperative conversions, and postoperative complications were retrospectively assessed.Outcomes were analyzed descriptively.Results: The superficial temporal artery was successfully used in 18 of 20 patients (90%, 18/20), with the superficial temporal vein providing venous drainage in 17 of these 18 cases (94.4%, 17/18).Two of 20 patients (10%, 2/20) required intraoperative conversion because of inadequate temporal venous caliber, one to cervical recipient vessels and the other to pedicled reconstruction.Among the 18 reconstructions utilizing the superficial temporal artery, one total flap loss occurred (5.6%, 1/18), resulting in a flap survival rate of 94.4% (17/18).Partial flap necrosis was observed in three.An additional total flap loss occurred following conversion to cervical vessels.Conclusions: The superficial temporal vessels represent a feasible recipient option in selected complex maxillofacial reconstructions, with flap survival rates of 94.4% (17/18) among cases utilizing the superficial temporal artery and 89.5% (17/19) across all free flaps.Inadequate venous caliber remains an important cause of intraoperative conversion.Larger prospective multicenter studies incorporating standardized vessel assessment are needed to further define the clinical role of these recipient vessels.